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The British state has a bad case of long covid

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The Economist

Mar 20, 2025 09:24 AM IST

In London relatives of the deceased threw carnations into the Thames, as a piper played a lament.

Coronavirus in Britain is a story of individual grief and collective amnesia. The fifth-anniversary commemorations on March 9th, which had been designated a “Day of Reflection” by the government, were dignified but modest. In London relatives of the deceased threw carnations into the Thames, as a piper played a lament. Around them, joggers plodded, tourists gawped and drinkers toasted the first pint of the day in glorious spring sunshine. The television schedules—“Songs of Praise”, “Gladiators”—went undisturbed. This is a sentimental country, where Armistice commemorations seem to grow bigger each year and new statues are erected to local heroes. But mention the pandemic, the biggest calamity in living memory, and you will be met by a wince and a change of subject. The memory is less of the neighbourliness and Zoom yoga, more of bitterness and boredom.

FILE - A healthcare worker fills a syringe with the Pfizer COVID-19 vaccine at Jackson Memorial Hospital on Oct. 5, 2021, in Miami. VAIDS is not a real condition, experts say. The co-authors of the study say their work is being misrepresented and doesn’t show that the vaccine is harmful to the immune system. The false claim is spreading as U.S. health officials recommend most Americans receive an updated COVID-19 vaccine. (AP Photo/Lynne Sladky, File)(AP) PREMIUM

Britons may choose to forget covid-19, but it has not forgotten them. The British state is suffering from a form of long covid. Pick a chart of public-service performance and, most likely, March 2020 will stand out as the point where middling turns dire. Coronavirus has produced a bigger state which provides a worse service. What appeared to be short-term backlogs have become an entrenched overload. It is the story of a machine that was turned off for two years and will not fully restart.

Britain hit covid hard. Its lockdown was longer than those of most of its peers, totalling 120 days of national “stay at home” orders. It had one of the bigger fiscal responses. Its health service cancelled drastically more hip, knee, cataract and mastectomy procedures. For all that, the death toll was among the highest in the rich world.

Whitehall misjudged how persistent the resulting queues would be. Some 7.4m cases are waiting for elective NHS treatment, a figure that has fallen glacially from its peak in September 2023. A target set in 2022 to eliminate year-long waits by this month looks certain to be missed. That year the Ministry of Justice boasted it had tamed its backlog of crown-court cases. But the backlog reached 73,000 last autumn. It “is almost out of control”, according to Shabana Mahmood, the justice secretary, and is expected to rise unstintingly without drastic reforms. The waiting time for driving tests has grown from weeks to months; officials were slow to realise they were dealing with more than a passing blip.

Therein lies a productivity problem. Covid came at a time when the state was running hot. Capital budgets had been cut, leaving creaking IT systems, an NHS with fewer beds per patient than its peers and court buildings in disrepair. Strikes broke out as low morale combined with high inflation. And so as money was tipped into services after the pandemic, a growth in employees was not matched by rising output. Public-sector productivity was last year only nine-tenths of where it stood in 2019. In the NHS staff numbers were up by 19%, but patients by only 14%. Court sitting days have swelled, as has the proportion that are wasted because files are unprepared or prison vans don’t turn up; delays beget delays, because as cases get older evidence goes stale. Covid has left a bigger, more sluggish state.

Like the social-distancing signs that remain on town-hall floors, some pandemic measures have stuck. A protocol of keeping prisoners in their cells for most of the day has persisted in some jails; it makes inmates easier to manage, but it is ruinous for rehabilitation. Claims for sickness and disability benefits have grown rapidly. Ministers blame the cessation of in-person assessments, which were routine before covid, and have promised to reinstate them.

The state has become less effective in part because the public has become less compliant. Pupil-absence rates are up, and are liable to persist until the cohort that started secondary school in 2020 finish their studies. The Office for National Statistics reports that, as elsewhere, people are now much less inclined to answer surveys. Shoplifting has risen markedly. You can find different explanations, but overlay them and it suggests something has slipped in the contract between citizens and government.

The mismatch between the legacy of covid and Britons’ willingness to hear about it makes for invidious politics. Ask Rishi Sunak: at a general-election debate in Grimsby he blamed Britain’s high tax burden on the covid-era furlough scheme, which at £70bn (2.9% of GDP in 2021) was among the most generous in the world; he was met with groans. With heroic levels of productivity growth, the suppression of demand and considerable luck, Sir Keir Starmer might just meet his target of bringing NHS waiting times to where they stood in the mid-2010s. But even in the best-case scenario he will be able to tell the electorate only that their services have undergone one rather than two wasted decades.

When the clapping stops

In lockdown Sir Keir would often invoke the Labour government of 1945. This was a nostalgic story of how the collective trauma of the war was the crucible that produced the welfare state. Like Clement Attlee, he vowed to build from the rubble of covid “a country worthy of the sacrifices of the British people”.

A closer reading of history serves not so much as an inspiration but rather as a lesson of what happens when a crisis persists beyond the public’s patience. The euphoria which greeted victory in 1945 soon gave way to grumbling; food rationing got stricter and would drag on for years. In the general election of 1951 Attlee got the boot, and Winston Churchill returned to power with a promise to leave wartime privation behind with an era of “freedom and abundance”. Consider it a warning. Britons want to forget the pandemic; they will punish a government that fails to alleviate many of its consequences.

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